■骶髂关节(SIJ)疼痛最有效的注射治疗方法尚不清楚。这项研究的目的是量化可用的注射策略的安全性和有效性,以解决SIJ疼痛。
■在PubMed,Scopus,和Embase数据库从成立到2023年1月。纳入标准是用英语写的研究,比较和非比较研究,无论最低限度的随访,和关于SIJ注射的案例系列。对SIJ的不同注射疗法的安全性和功效进行定量。对记录的注射疗法的可用数据进行荟萃分析。DownsandBlack的“质量测量清单”用于评估偏倚风险和论文质量。
■文献检索到43篇论文(2431例患者):16例回顾性病例系列,2个回顾性比较研究,17个前瞻性病例系列,3个前瞻性比较研究,5项随机对照试验。在选定的研究中,63%的人检查了类固醇注射的效果,16%的PRP注射剂,而21%的人报告了其他异质治疗。类固醇注射的失败率为26%,PRP注射的失败率为14%。荟萃分析显示,类固醇和PRP的VAS评分在疼痛方面均有统计学意义的降低:中期类固醇改善3.4分(p<0.05),在长期3.0(p<0.05),PRP中期改善2.2(p=0.007),在VAS疼痛评分的长期2.3分(p=0.02)。
■类固醇是记录最多的注射方法,研究显示整体安全性和有效性。尽管如此,一些研究强调的大量失败表明需要替代手术。早期PRP数据显示出希望,但是当前文献的局限性不允许明确定义最合适的内射方法,需要进一步的研究来确定SIJ患者的最佳注射治疗。
UNASSIGNED: The most effective injective treatment approach for sacroiliac joint (SIJ) pain remains unclear. Aim of this study was to quantify the safety and effectiveness of the available injective strategies to address SIJ pain.
UNASSIGNED: A systematic review and meta-analysis of the literature was conducted on PubMed, Scopus, and Embase databases from inception until January 2023. Inclusion criteria were studies written in English, comparative and non-comparative studies regardless of the minimum follow-up, and case series on SIJ injections. Safety and efficacy of the different injection therapies for the SIJ were quantified. A meta-analysis was conducted on the available data of the documented injective therapies. The \"Checklist for Measuring Quality\" by Downs and Black was used to assess the risk of bias and the quality of papers.
UNASSIGNED: The literature search retrieved 43 papers (2431 patients): 16 retrospective case series, 2 retrospective comparative studies, 17 prospective case series, 3 prospective comparative studies, and 5 randomized controlled trials. Of the selected studies, 63% examined the effect of steroid injections, 16% of PRP injections, while 21% reported other heterogeneous treatments. The failure rate was 26% in steroid injections and 14% in PRP injections. The meta-analysis showed a statistically significant reduction in pain with the VAS score for both steroids and PRP: steroids improvement at mid-term 3.4 points (p < 0.05), at long-term 3.0 (p < 0.05), PRP improvement at mid-term 2.2 (p = 0.007), at long-term 2.3 points of the VAS pain scale (p = 0.02).
UNASSIGNED: Steroids are the most documented injective approach, with studies showing an overall safety and effectiveness. Still, the high number of failures underlined by some studies suggest the need for alternative procedures. Early PRP data showed promise, but the limitations of the current literature do not allow to clearly define the most suitable injective approach, and further studies are needed to identify the best injective treatment for SIJ patients.